비정기적 교수개발자의 정체성 개발(Acad Med, 2014)
Identity Formation of Occasional Faculty Developers in Medical Education: A Qualitative Study
Patricia S. O’Sullivan, MS, EdD, and David M. Irby, MDiv, PhD
특정 주제, 교수-학습 향상을 위한 활동, 프로세스 등에 초점을 둔 교수 개발 연구와 대조적으로, 교수개발자들에게만 초점을 둔 연구는 소수이다. 연구자들은 경험이 늘어남에 따라 풀 타임 교수개발자가 교사 중심에서 학습자 중심 모델로 전환하고, 8은 교수개발자로서의 정체성이 solidify되는 데 2 년에서 4 년이 걸린다는 것을 찾아내었다.
In contrast to faculty development research that focuses on a single topic,2 activities to improve teaching and learning,5,6 and processes,7 only a few studies focused on the faculty developers themselves. The researchers found that, with increased experience, fulltime faculty developers shift from a teacher centered to a learner centered model,8 take two to four years to solidify the faculty developer identity,9
의과 대학 교수진은 종종 임상의, 연구자, 교육자 및 관리자로서의 역할과 관련된 여러 정체성을 통합하고 협상합니다 .11,12 Monrouxe11에는 4 가지 정체성 정렬 모델이 정의되어 있으며 이들이 의학 교육자에게 어떻게 적용될 수 있는지 제안했습니다 12.
(1) 구획화 된 정체성: 때로는 의사 / 과학자이고 다른 때는 교육자이다.
(2) 계층적 정체성: 의사 / 과학자가 교육자보다 상위에 위치하거나 그 반대 인 경우;
(3) 평행적 정체성: 동시에 존재하지만 의식적인 중복이 없는 상태
(4) 통합된 정체성: 동시에 통합되어 공존하는 상태.
Medical school faculty members often incorporate and negotiate multiple identities associated with their roles as clinicians, researchers, educators, and administrators.11,12 Monrouxe11 des cribes four identity alignment models, and we have suggested how these might apply to medical educators12: (1) compartmentalized identities, where at times one is a physician/scientist and at other times one is an educator; (2) hierarchical identities, which place being a physician/scientist over being an educator or vice versa; (3) parallel identities that exist simultaneously but without a conscious overlap; or (4) merged identities that are integrated and coexist simultaneously.
우리는 FD는 교수들이 모여 교수 학습을 개선하는 방법을 배우고 토론 할 수있는 교습의 장을 마련한다는 것을 알게되었습니다 .14 그러나 우리는 또한 성공적인 FD는 워크숍을 뛰어 넘어 참가자들의 일상이나 교실과 클리닉에서 직장에서의 실천공동체까지도 포함한다고 주장했습니다 .
We recognized that faculty development creates a teaching commons where faculty members come together to talk about and learn how to improve teaching and learning.14 However, we also asserted that successful faculty deve lopment extends beyond work shop(s) to include the participants’ everyday life in their workplace or community of practice in classrooms and clinics.
네 가지 정체성 정렬 모델에 의해 프레임, 우리의 연구 질문은 다음과 같습니다 :
(1) 이 교수개발자들은 어떻게 자신의 정체성과 그 형성을 설명합니까?
(2) 교수개발자로서의 역할이 일상 생활에 어떤 영향을 미치나요?
(3) 교수개발자로서의 역할은 교수개발자, 교수 교습과 더 큰 교수법 공동체에 어떤 영향을 미칩니 까?
Framed by the four identity alignment models, our research questions are as follows: (1) How do these faculty deve lopers describe their identity and its formation? (2) How does being a faculty developer affect one’s everyday work? and (3) What impact does the faculty development role have on the faculty developer, the teaching commons, and the larger community of teaching practice?
Method
Design
We conducted a qualitative study using structured interviews guided by the identity formation and faculty development literatures.
Setting and participants
Since 2007, the University of California, San Francisco (UCSF) School of Medicine’s faculty development program has offered approximately 30 two to four hour workshops per year. Attendees are primarily faculty members in the UCSF School of Medicine but also include faculty from dentistry, nursing, pharmacy, and physical therapy.
All workshops are conducted in person. Individuals recruited to teach in the faculty development program are recognized as good teachers and/or have expressed a strong interest in a specific topic. The leaders of faculty development know many of these teachers of the faculty development offerings because they have participated in the local longitudinal faculty development program (see http://meded.ucsf.edu/ radme/teachingscholarsprogram), thus ensuring that they have a broad background in educational pedagogy and curriculum development.
We purposively excluded individuals from UCSF School of Medicine’s Office of Medical Education who held doctorates in education or were prepared as educational specialists.
Interview guide
Both of us (P.S.O’S., D.M.I.) developed the interview guide based on identity formation and faculty development literatures (see Supplemental Digital Appendix 1, http://links.lww.com/ ACADMED/A217). The guide had two questions on demographics and eight questions on identity, including ones about
early formation as an educator,
motivation to do faculty development,
impact of faculty development on themselves and others,
professional roles,
career trajectories, and
impact on their work environments.
Each question had one to six probes; none were specific to the models of Monrouxe11 or O’Sullivan and Irby.13 We piloted the guide with educators not included in the study. For this study, we focused on six questions (see Appendix 1).
Qualitative approach
This qualitative study used a modified grounded theory approach sensitized by the literature on identity and faculty development.11,13 Both authors are doctorally prepared educators with training and experience in conducting qua litative research. We knew all of the individuals interviewed, though to varying degrees. Despite the familia rity, we assumed that because the interview did not ask about the faculty develop ment program one of us (P.S.O’S.) runs or about the value of the program, the participants would be able to respond to our questions without feeling influenced. As interviewers, we took a naïve stance toward the questions and adhered to the interview guide.
Procedures
Thirty participants were solicited via email to participate in 30 to 60minute interviews, and no incentives were offered. We conducted interviews in person or over the telephone from March 2012 through April 2012. We took extensive field notes during the interviews. The interviews were also audiotaped and transcribed. We debriefed the initial interviews and refined questions. Subsequently, we maintained an analytic memo docu menting our joint reflections and revisions to the interview guide.
Analysis
After reviewing the first six transcribed interviews in May 2012, we jointly developed codes in accordance with identify formation and faculty development frameworks. We augmented our codes on the basis of detailed notes taken during each interview, which we also discussed jointly. In our final codebook from September 2012, we generated 139 detailed codes and then clustered them into 55 broader codes. Those codes were applied to the transcripts and managed using NVivo qualitative data analysis software, version 10.0 (QSR International, Melbourne, Australia). We then formed themes from the codes informed by theory and in response to our research questions. We conducted a member check by having participants review an initial draft of our manuscript. All of those who responded endorsed our interpretations and findings as an accurate reflection of their perceptions.
Results
All 30 invited faculty members agreed to participate, and we successfully interviewed 29 (97%).
This included
25 (86%) physician educators and 4 (14%) basic science educators;
5 (17%) assistant professors, 12 (41%) associate professors, and 12 (41%) professors; and
8 (28%) males and 21 (72%) females.
Participants reported having conducted faculty development workshops for between 1 and 22 years. Assistant and associate professors had 3 to 3.5 years of faculty development experience, whereas full professors averaged 11.6 years. List 1 provides the workshop topics that these faculty developers offered.
연구질문1: 교수개발자들이 자신의 정체성과 그 형성에 대해 어떻게 묘사하는가?
Research question 1: How do these faculty developers describe their identity and its formation?
일차적 정체성
Primary identity.
참가자는 다음 네 가지 방법 중 하나를 사용하여 기본 정체성을 설명했습니다.
Participants described their primary identities in one of four ways:
1. 임상의의 정체성이 지배적인 임상가 교육자.
1. Clinician educators, where their clinician identity predominates.
2. 교육자 정체성이 기본인 임상가 교육자 또는 과학자 교육자 (기초 과학자 용)..
2. Clinician educators or scientist educators (for basic scientists), where their educator identity is primary.
3. 교육자가 유일한 정체성.
3. Educator, where this is the sole identity.
4. 멘토, 고문, 학자, 교수개발자 등 여러 역할이 자신의 정체성을 특징 짓는 리더 및 행정가 (예 : 과정 또는 사무원 또는 거주 프로그램 디렉터, 커리큘럼 학장, 부서장).
4. Leaders and administrators (e.g., course or clerkship or residency program directors, curriculum dean, department chair), where multiple roles of mentor, advisor, scholar, and faculty developer characterize their identities.
교수개발자로서의 정체성
Identity as a faculty developer.
우리 응답자 중 누구도 자신을 교수개발자로 인식하지 않았지만 몇몇 교사는 스스로를 "선생님의 선생님"라고 묘사했습니다 (MD1).
Whereas none of our respondents saw themselves primarily as a faculty developer, several described themselves as “a teacher of teachers” (MD1).
많은 참가자들의 정체성은 결국 교수개발자를 포함하는 방향으로 진화했습니다. 그 실현은 세 가지 다른 관점에서 비롯된 것입니다. 개인 정체성의 일부로 통합 된 일부 교수진 개발자 :
Many participants’ identities evolved to eventually include faculty developer. That realization came from three different perspectives. Some incorporated faculty developer as part of their personal identity:
동료들에게 기대되는 교육의 질을 달성하는데 필요한만큼 교수 개발을 고려했습니다.
Others considered faculty development as necessary to achieve the quality of teaching expected of their colleagues:
고품질의 프리셉터를 모집하고 의대생이 훌륭한 교육 경험을 갖출 수 있기를 원한다면 그 사람들을 양성 할 수 있어야합니다. (MD4)
If you want to be able to recruit high quality preceptors and ensure that your medical students have good educational experiences, you have to be able to train those folks. (MD4)
세 번째 관점에서, 일부는 교수진 개발이 그들이하는 일과 관계없이 pervasive되어 있다는 것을 인식했습니다.
In the third perspective, some recognized that faculty development is pervasive regardless of what they do:
요약하면, 우리는 참가자들이 일차적 정체성에서 출발하여, 교수개발자로서의 정체성을 공유한다는 것을 알게되었습니다. 그 정체성의 강도는 상당히 다양했으며, 종종 그들의 프로그램에서 교수법을 향상시킬 필요성과 관련되어있었습니다.
In summary, we found that participants come from a primary identity and do share a faculty developer identity. The strength of that identity varied considerably and was often associated with the need to improve teaching in their programs.
정체성 정렬
Identity alignment.
정체성은 교수개발과 specific하게 연결되어있기도 했지만, 그보다는 교수개발자를 포괄하는 "교육자"로서의 더 넓은 차원에서의 정체성과 연결되어 있었다.
Participants described their current identity in one of the four identity alignment models reported in the literature; sometimes this identity was connected specifically to their faculty development identity, but more often the identity was associated with their broader identity as an educator, which included faculty developer.
구획화된 정체성
Compartmentalized identity.
아주 드물게만 교수개발 워크숍을 진행하는 일부 주니어 교수들이 이 모델을 언급함.
A few junior faculty members who rarely conducted faculty development workshops mentioned the compartmentalized identity model, in which they saw their faculty development work completely separate from their clinical and/or teaching work (Figure 1A).
위계적 정체성
Hierarchical identity.
Some faculty members viewed their identities hierarchically, with one taking precedence over another (Figure 1B).
평행적 정체성
Parallel identity.
For some participants, their multiple roles formed identities that were parallel, with minimal overlap (Figure 1C).
인터뷰를 하는 과정에서 parallel에서 merged 로 변화해갔다.
Interestingly, over the course of the interview, many transitioned from describing themselves as a parallel to a merged identity.
통합된 정체성
Merged identity.
여러 역할이 고도로 통합되고 서로 영향을 주는 상태
The merged identity was described as all roles becoming highly integrated and influencing the others. Some participants identified this merged identity through the lens of faculty developer (Figures 1D and 1E).
교사로서의 정체성 형성
Teacher identity formation.
교육자로서 자신의 정체성 형성을 반영하듯, 한 참가자를 제외하고는 초기부터 모두 스스로를 교사로 보았습니다. 그들은 초등 학교, 고등 학교를 지나고 professional preparation을 거쳐 교수가 되기까지의 과정에서 교육에 대한 열정을 발견했습니다.
Reflecting on their own identity formation as educators, all but one participant saw themselves as teachers early on. They described discovering their passion for teaching from elementary school to high school to professional preparation through to being a faculty member.
나는 내가 어린 시절부터 선생님이되고 싶다는 것을 알고있었습니다. (PhD2)
I knew I wanted to be a teacher from the time I was a little kid. (PhD2)
몇몇 참가자들은 자신의 정체성이 자신의 커리어 과정에서 진화했다는 것을 알고 있으며, 예상했던 방향과 전혀 다른 방향으로 움직이는 경우가 종종 있습니다. 그들이 시니어가 됨에 따라 멘토링과 교수개발 간의 관계가 더욱 분명 해졌다.
Several participants recognized that their identity evolved over the course of their careers, often moving in quite different directions than they had anticipated and sometimes changing from year to year. As they became more senior, the relationship between mentoring and faculty development became more apparent.
연구질문2: 교수개발자가 된다는 것이 커리어와 일상생활에 미치는 영향은?
Research question 2: How does being a faculty developer affect one’s career and everyday work?
커리어에 미치는 영향
Impact on career.
응답자의 대다수에 따르면, 교수개발을 진행하며 경력이 향상되었다. 그들은 종종 전국 회의 및 기타 기관에서 지역 워크숍을 개최했습니다. 이러한 가시적 성과와 보급은 자신의 지역내에서의 위상을 높이고 발전과 승진에 도움을 주었습니다. 새로운 기회는 지역 및 전국 교육위원회, 교육 리더십 직책 (예 :위원회 위원장, 사무장, 레지던트 프로그램 디렉터 및 부서장)을 포함하여 교수진으로서의 활동으로 인해 발생했습니다.
According to the majority of respondents, conducting faculty development advanced their careers. They often presented their local workshop at national meetings and other institutions. This visibility and dissemination increased their stature locally and helped with their advancements and promotions. New opportunities arose as a result of their work as a faculty developer, including appointments to local and national education committees, and to educational leadership positions (e.g., committee chairs, clerkship directors, residency program directors, and department chairs).
일상생활에 미치는 영향
Impact on everyday work.
또한 교수개발 워크숍이 일반적인 기술 (예 : 피드백, 의사 소통, 임상 적 추론, 임상 교육)을 다루는 경우, 이것이 어떻게 일상적인 업무까지 확장되는지에 대해 말했다. 교수개발자는 일관되게 자신의 교육에서 이 내용을 사용했으며, 종종 환자를 볼 때도 마찬가지였습니다. 이들은 콘텐츠 (예 : 효과적인 의사 소통)가 자신의 교수 (예 : 학습자 및 환자와의 의사 소통)에 정보를 제공해 주고, 반대로 자신의 교육이 교수개발에 도움을 주는 호혜적 또는 교환 프로세스를 설명했습니다.
Additionally, they conveyed how their faculty development role extended into their everyday work, which occurred especially when their faculty development workshops covered general skills (e.g., feedback, communication, clinical reasoning, clinical teaching). Faculty developers consistently drew on this content in their teaching and often even when working with patients. These developers described reciprocity or an exchange process in which the content (e.g., effective communication) informed their teaching (e.g., communication with learners and patients) and their teaching informed their faculty development.
연구질문3: 교수개발 역할이 교수개발자, 교육공동체, 실천공동체에 미치는 영향은?
Research question 3: What impact does the faculty development role have on the faculty developer, the teaching commons, and the community of practice?
교수개발자
Impact on the faculty developer.
교수진 개발 워크샵을 주도한 결과, 참가자들은 자신들이 신뢰와 전문성을 가지고 있다고 생각하고 존경심을 나타 냈습니다.
As a result of leading faculty development workshops, participants reported that others viewed them as having credibility and expertise, and accorded them respect.
이것은 자신의 지위를 상승 시켰을뿐만 아니라 스스로를 어떻게 보았는지를 바꾸었습니다. 많은 사람들이 교육에 더 많이 참여하고 전문 네트워크를 확대하여 교육 및 연구 분야에서 새로운 협력 관계를 창출했습니다. 워크샵은 교수개발자가 참석자들과 교육 연구에 관해 깊은 대화를 나눌 수있는 기회를 제공하였고, 이로 인해 faculty vitality가 더 향상되었다. 우리가 확인한 테마는 교수개발자 자신과 네트워크에 미치는 영향, 그리고 기관이 자신의 신원을 발전 시키는데있어 수행 한 역할에 관한 것입니다.
This not only elevated their status but also changed how they viewed themselves. Many were invited to engage more in education and expanded their professional networks, creating new collaborations in teaching and research. The workshops offered opportunities for faculty deve lopers to have deep conversations about educational scholarship with attendees, which further supported faculty vitality. The themes we identified related to the impact on the developers themselves and on their network, and the role their institution played in the development of their identities.
교수개발이 자기 이미지에 미치는 영향
Relating to the impact of faculty development on their self image,
교수개발자가 되어서 네트워크가 어떻게 넓어졌는가
Citing how being a faculty developer broadened their network,
교수개발자 정체성을 개발하는 데있어 기관의 역할을 연계 시키며,
Linking the role of the institution in developing their faculty developer identity,
기관
Impact on the institution.
참가자들은 교수개발 프로그램이 기관 문화의 일부가 되었다고 보고했다. 교수개발 프로그램에서 가르침으로써, 그들은 비슷한 생각을 가진 교사 공동체의 일부가 되어서 가르치고 배우는 것에 관한 공통 언어를 만들어 공유하였고, 교육 문제를 심도있게 토론하였으며, 다른 교수들과의 더 깊은 인간적인 관계를 형성하였다. 교수개발 프로그램은 또한 교사의 형성을 지원하고 학술적 접근을 장려했습니다. 또한 교수개발자로서 했던 것들이 교육 및 환자 치료에서의 전문적인 실천 공동체에 직접적으로 translate된다는 것을 인식하였다.
Participants reported that the faculty development program has become part of the insti tutional culture. By teaching in the faculty development program, they became part of a community of like minded teachers who created and shared a common language about teaching and learning, and who discussed educational issues indepth, fostering deeper inter personal relationships with other teach ing faculty. The faculty development program also encouraged a scholarly approach to teaching and supported the formation of teachers. Additionally, they recognized that what they did as developers translated directly into their communities of professional practice in teaching and patient care.
고찰
Discussion
우리는 교수개발자의 정체성이 시간이 지남에 따라 발전했으며 교수진의 임상의, 과학자 및 교육자 역할과 밀접한 관련이 있음을 발견했습니다. 대부분은 가르침에 강한 관심을 갖고 이 일을 시작했습니다. 교수진 개발을 통해 지위를 높이고 경력 향상 및 전문직 기회를 지원할 수 있었습니다. 많은 개발자에게 교수개발 워크숍 (예 : 피드백)에서 제공 한 주제가 환자 및 학습자와의 상호 작용에 직접적인 영향을 주었습니다. 또한 교수진 개발자로서 교육 커뮤니티를 확대하고 교육 기관의 교육 문화를 강화했습니다.
We found that faculty developer identity evolved with time and was closely related to the faculty members’ other roles as clinicians, scientists, and educators. Most came to this work with a strong interest in teaching. Providing faculty development clearly elevated their status and supported career advancement and professional oppor tunities. For many developers, the topic that they offered in faculty deve lopment workshops (e.g., feedback) had a direct impact on their interactions with patients and learners. Additionally, as faculty developers they expanded their teaching community and strengthened the educational culture of the institution.
As we anticipated in our model, faculty developers often extended their roles in the “teaching commons” of work shops to include mentoring and edu cational consultation in the work place.
- 처음 두 모델 (구획화 된, 계층적)에서 교수개발자의 정체성은 주로 교육자로서의 정체성과 관련이 있습니다.
- 병렬 정체성은 아마도 설명하기가 가장 어렵습니다. 이 정렬의 주요 특징은 참여자의 다양한 정체성에 대한 설명으로 완전히 분리되지는 않았지만 병합되지 않았기 때문에 서로 강한 연관성없이 평행하게 존재했다.
- 통합된 정체성의 경우 두 가지 모델을 생성했습니다. 그림 1D에서 MD / PhD, 교육자 및 교수진의 역할이 완전히 병합됩니다. 그러나 그림 1E에서 교수진 개발자 신원은 주로 교육자 신원에서 합병되었지만 3 가지 중 하나가 다른 것의 계층 구조가 아닌 방식으로 합병되었습니다.
In the first two models—compartmentalized and hierarchical—the faculty developer identity was primarily related to their identity as an educator. The parallel identity is perhaps the most difficult to describe. The key distinctive features of this alignment are the participants’ descriptions of their various identities that were not completely separate but were also not merged—they existed in parallel without a strong connection to each other. For the merged identity, we generated two different models. In Figure 1D the roles of MD/PhD, educator, and faculty developer fully merge. However, in Figure 1E the faculty developer identity merged primarily within the educator identity but not in a way that any one of the three was hierarchical to the others.
The ability to incorporate the faculty developer identity appeared to be a function of the workshop topic that they presented, the stage of their career development, and the frequency with which they provided faculty development. Participants described fluidity in their identities that shifted as their roles and responsibilities changed over time. Although most experienced faculty developers labeled their identities as merged, especially as their educator roles evolved and expanded, there were a few experienced faculty developers whose identities remained compartmentalized. Conversely, a few junior faculty members had merged identities.
Additionally, it is consistent with literature indicating that at many institutions, faculty developers move into leadership roles.1
We found that even being an occasional faculty developer changed individuals’ identities, practices, collegial networks, advancements, and future professional opportunities. Individuals could link the work they did in faculty development to specific effects on their careers and their identities. Participants frequently mentioned the sense of being a credible source and an expert, and they were able to parlay this expertise into opportunities that advanced their careers.
Participants also described the impact that the institution had on them, as well as the impact the faculty development program had on the institution. One of our participants used the analogy of the “chicken or the egg,” suggesting that a strong faculty development program enhances the value of education in the institution, which in turn values what the developers offer.
Our findings offer encouragement to those considering becoming faculty developers, because participation bes towed significant benefits and miti gated the isolation and lack of support identified by many as reasons for leaving academic careers in medicine.18 In addi tion to the identified prestige derived from teaching peers, teaching faculty development expanded developers’ networks and roles in departments, schools, and national professional asso ciations. Our participants found the community of other faculty developers important to their sense of satisfaction and wellbeing as educators. These deve lopers worked in teams, watched and learned from each other, and received considerable feedback about their performance from learners, coinstructors, and leaders in faculty development.
우리의 연구에는 몇 가지 한계가 있습니다. 그것은 강력한 교육 문화로 유명한 단일 기관에서 실시되었으며, 특유의 교수진 개발 모델을 사용합니다. 대부분의 train the trainer TOT 모델과는 달리, 20-22 UCSF의 모델은 정기적으로 워크샵을 제공하는 훌륭한 교사 그룹의 개발과 지원에 달려 있습니다. 어떤 모델도 모든 기관에 적합하지 않을 것입니다 .17 또 다른 제약은 한 프레임의 정체성을보고 다른 프레임이 가능하다는 것을 인정한다는 것입니다.
Our study has a few limitations. It was conducted in a single institution that is noted for a strong culture of education, and it uses a distinctive faculty development model. Unlike most train thetrainer models,20–22 UCSF’s model depends on the development and support of a large group of excellent teachers who provide workshops periodically. No one model will fit all institutions.17 Another limitation is that we looked at identity from one framing and acknowledge that other framings are possible.
2 Skeff KM, Stratos GA, Mount JFS. Faculty development in medicine: A field in evolution. Teach Teach Educ. 2007;23:280–285.
7 Amundsen C, Wilson M. Are we asking the right questions? A conceptual review of the educational development literature in higher education. Rev Educ Res. 2012;82:90–126.
17 Austin AE, Sorcinelli MD. The future of faculty development: Where are we going? New Dir Teach Learn. Spring 2013:85–97.
18 Pololi LH, Krupat E, Civian JT, Ash AS, Brennan RT. Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intentions to leave at 26 representative U.S. medical schools. Acad Med. 2012;87:859–869.
19 Goldie J. Assessment of professionalism: A consolidation of current thinking. Med Teach. 2013;35:e952–e956.
Appendix 1 Six Questions Focused on in a 2012 Qualitative Study on Identity Formation of University of California, San Francisco School of Medicine’s Faculty Developers From 2007 to 2012a
Acad Med. 2014 Nov;89(11):1467-73. doi: 10.1097/ACM.0000000000000374.
Identity formation of occasional faculty developers in medical education: a qualitativestudy.
Author information
- 1Dr. O'Sullivan is professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Irby is professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
Abstract
PURPOSE:
METHOD:
RESULTS:
CONCLUSIONS:
- PMID:
- 24979283
- DOI:
- 10.1097/ACM.0000000000000374
- [PubMed - indexed for MEDLINE]
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